HomeMy WebLinkAbout6.j. Approve MDH Sealing Unused Public Water Supply 4ROSEMOUNTEXECUTIVE SUMMARY
CITY COUNCIL
City Council Meeting: January 20, 2015
AGENDA ITEM: Approve MDH Sealing Unused Public AGENDA SECTION:
Water Supply—Well Grant Consent
PREPARED BY: Andrew J. Brotzler, PE, Director of P is AGENDA NO. '�
Works/City Engineer ,
ATTACHMENTS: January 5, 2015 MDH Letter; Grant
Agreement; Location Map APPROVED BY:
RECOMMENDED ACTION: Motion to Approve the Sealing Unused Public Water Supply -
Well Grant Agreement and Authorize the Necessary Signatures.
ISSUE
Staff is seeking City Council approval and execution of the Minnesota Department of Health Grant
Agreement 87492.
BACKGROUND:
Attached for City Council consideration is a Grant Agreement with the Minnesota Department of Health
to accept up to $13,860 from the MDH. This grant was applied for on December 1, 2014 to secure
funding to seal well 4 which was abandoned, but does not have a MDH sealing record.
SUMMARY:
Staff recommends that the City Council authorize the execution of the Minnesota Department of Health
Grant Agreement.
G:\ENGPROJ\ENG 0093-Wellhead Protection Plan\20150120 Approve Grant Authorize Signatures.docx
M I N N E S O T A
MDH
DEPARTMENT oFHEALTH
Protecting, maintaining and improving the health of all Minnesotans
January 5, 2015
Mr. Andy Brotzler
City of Rosemount
2875 145th Street West
Rosemount, Minnesota 55068-4997
Subject: Sealing Unused Public Water-Supply Well Grant
Dear Mr. Brotzler:
On December 1, 2014, the Minnesota Department of Health (MDH) received a Sealing Unused
Public Water-Supply Well Grant Application to seal Well Number 4. MDH is pleased to inform
you that the city of Rosemount is receiving funding to seal the well.
MDH reviewed and scored your application using the predetermined scoring method that was
included in MDH's Request for Proposals. MDH took the highest cost estimate provided and
deducted the costs that are ineligible under the grant. Based on the score and the highest cost
estimate, MDH is providing up to $13,860 for its cost share to seal Well Number 4. Actual
payment will be based on the contractor's actual invoice, minus any ineligible costs, and the Well
Sealing Invoice submitted to MDH when the well is properly sealed.
Enclosed are three copies of the Grant Agreement (agreement) between MDH and the city of
Rosemount. Please review the agreement and sign the last page of each agreement. All three
copies must be signed and returned to me. A fully executed agreement will be returned to you
after MDH signs the agreements.
The city of Rosemount determines which contractor to hire to seal Well Number 4. Well sealing
activities may begin when the fully executed agreement is returned to you. No work can begin
until you receive the fully executed agreement. Any work conducted prior to receiving the fully
executed agreement will not be funded.
General Information: 651-201-5000 • Toll-free: 888-345-0823 • www.health.state.mn.us
An equal opportunity employer
Mr. Andy Brotzler
City of Rosemount
Page 2
January 5, 2015
You will be the State's contact for all future communications and correspondence relating to the
agreement. If you have any questions about the agreement, please contact me at 651-201-3651.
Sincerely,
A).,y,), a. A P,‘..( .--
Nancy Jo A. La Plante, Grant Coordinator
Well Management Section
P.O. Box 64975
St. Paul, Minnesota 55164-0975
NJL:kad
Enclosures
M I N N E S 0 T A Standard Grant Template Version 1.4,6/14
MDHGrant Agreement Number g 7(117—
DEPARTMEHT0F HEALTH Between the Minnesota Department of Health and the city of Rosemount
If you circulate this grant agreement internally,only offices that require access to the tax identification number AND all individuals/offices signing this grant agreement
should have access to this document.
Minnesota Department of Health
Grant Agreement
This grant agreement is between the State of Minnesota, acting through its Commissioner of the
Department of Health ("State") and the city of Rosemount ("Grantee"). Grantee's address is 2875 145th Street
West, Rosemount, Minnesota 55068-4997.
Recitals
1. Under Minnesota Statutes 144.0742 and Minnesota Statutes 114D.50 Clean Water Fund, the State is
empowered to enter into this grant agreement.
2. The State is in need of providing funding to public water-supply well owners to seal their unused wells.
3. The Grantee represents that it is duly qualified and will perform all the duties described in this agreement to
the satisfaction of the State. Pursuant to Minnesota Statutes section 16B.98, subdivision 1, the Grantee agrees
to minimize administrative costs as a condition of this grant.
Grant Agreement
1. Term of Agreement
1.1 Effective date January 12, 2015, or the date the State obtains all required signatures under Minnesota
Statutes section 16C.05, subdivision 2, whichever is later.
The Grantee must not begin work until this contract is fully executed and the State's Authorized
Representative has notified the Grantee that work may commence.
1.2 Expiration date June 30, 2016, or until all obligations have been fulfilled to the satisfaction of the
State, whichever occurs first.
1.3 Survival of Terms The following clauses survive the expiration or cancellation of this grant contract: 8.
Liability; 9. State Audits; 10.1 Government Data Practices; 10.2 Data Disclosure; 12. Intellectual Property;
14.1 Publicity; 14.2 Endorsement; and 16. Governing Law, Jurisdiction, and Venue.
2. Grantee's Duties The Grantee, who is not a state employee, shall:
A. Hire a well contractor who is licensed by the State to seal Well Number 4 in accordance with Minnesota
Rules, part 4725.3850. The well contractor will also complete a Well and Boring Sealing Records;
B. Call Patrick Sarafolean at 651-201-3962 (office) or 651-335-7208 (cell) 48 hours before any well sealing
activities begin so MDH has the opportunity to inspect the well sealing procedures.
C. Contact Nancy La Plante, MDH grant coordinator, as soon as it is known that:
• cost of sealing the well will be greater than the Total Obligation as indicated in 4.1(b) below,
Page 1 of 8
M ' N N E s o T A Standard Grant Template Version 1.4,6/14
DHGrant Agreement Number
DEPARTMENT Of HEALTH Between the Minnesota Department of Health and the city of Rosemount
• the well indicated in the grant agreement won't be sealed,
• the scope of work will not be completed prior to the grant agreement expiring, or
• no well sealing activities will be conducted and the grant agreement needs to be canceled.
D. Complete a Public Water-Supply Well Sealing Grant Invoice (invoice) form for Well Number 4. The
Grantee may use the invoice form that is attached and incorporated as Exhibit A, or complete the form at
www.health.state.mn/divs/eh/cwl/sealing/pwinvoice.pdf;
E. Include only the following eligible costs on the MDH Well Sealing Invoice for the well sealing activities:
• investigative work by a MDH licensed well contractor to determine location and condition of a well;
• mobilization/demobilization;
• well reconstruction that is necessary to enable well sealing;
• removing debris and pumping equipment from the well;
• removing or perforating the well casing;
• sealing the well with grout, in accordance with Minnesota Rules, part 4725.3850;
• disposal fees associated with the proper disposal of materials associated with sealing the well; and
• the time, labor, and materials directly related to sealing the well.
F. Do not include the following ineligible costs on the MDH Well Sealing Invoice:
• any fees associated with inspections, notifications or permitting;
• administrative costs associated with preparing and submitting:
• a grant application and all associated documentation,
• a MDH Well Sealing Notification and Record,
• a MDH Sealing Public Water-Supply Well Grant Invoice, or
• any other administrative paperwork;
• costs associated with writing any reports;
• administrative or oversight costs by a general contractor if the well contractor is subcontracting;
• administrative or oversight costs by a consultant
• costs associated with re-landscaping or returning the well site back to its original condition;
• costs associated with returning to the well site to add more grout in the well due to the grout settling; and
• any amount exceeding one half of the actual eligible costs incurred to perform the work.
G. Include a copy of the licensed well contractor's itemized invoice. The well contractor's invoice must be
detailed (itemized) so it can be matched to the Well Sealing Invoice and thus represents actual costs associated
with sealing Well Number 4;
H. Ensure the licensed well contractor completes and submits the MDH Well and Boring Sealing Record for
Well Number 4; and
I. Submit the Well Sealing Invoice and the licensed well contractor's itemized invoice within 30 days of
completing the well sealing work to:
Nancy La Plante
Well Management Section
Minnesota Department of Health
P.O. Box 64975
St. Paul, Minnesota 55164-0975
nancyjo.laplante@state.mn.us
Page 2 of 8
M . 4 N E S O T A Standard Grant Template Version 1.4,6/14
DHGrant Agreement Number
DEPARTMENT 0/N EAETN Between the Minnesota Department of Health and the city of Rosemount
J. The Grantee shall pay in full any licensed contractor hired for the purpose of completing any work under this
grant agreement within 10 days of receiving payment from the State.
3. Time The Grantee must comply with all the time requirements described in this grant agreement. In the
performance of this grant agreement, time is of the essence, and failure to meet a deadline may be a basis for a
determination by the State's Authorized Representative that the Grantee has not complied with the terms of the
grant.
The Grantee is required to perform all of the duties recited above within the grant period. The State is not
obligated to extend the grant period.
4. Consideration and Payment
4.1 Consideration The State will pay for all services performed by the Grantee under this grant agreement
as follows:
(a) Compensation. The Grantee will be paid for all eligible costs indicated on the Well Sealing
Invoice that is submitted according to Items 2. E and F above, but not to exceed $13,860. MDH
will also hold payment until the Well and Boring Sealing Record is received.
(b) Total Obligation The total obligation of the State for all compensation and reimbursements to the
Grantee under this agreement will not exceed thirteen thousand eight hundred sixty dollars($13,860).
(c) Travel Expenses
The Grantee will not be reimbursed for travel and subsistence expenses.
(d) Budget Modifications. If total eligible costs for sealing the Grantee's well will exceed the
State's Total Obligation as indicated in 4.1(b), the Grantee must notify the State's grant
coordinator as soon as it's known. Modifications to the Total Obligation may be considered if
determined practical and if funding is available.
4.2 Terms of Payment
(a) Invoices The State will promptly pay the Grantee after the Grantee presents an itemized
invoice for the services actually performed and the State's Authorized Representative accepts the
invoiced services. Invoices must be submitted in a timely fashion and according to the following
schedule:
Within 30 days of completing the well sealing work.
(b) Matching Requirements Grantee certifies that the Grantee has the funds to support their 50
percent cost share.
Page 3 of 8
M I N N E S O T A Standard Grant Template Version 1.4,6/14
DHGrant Agreement Number
DEPARTMENT OF HEALTH Between the Minnesota Department of Health and the city of Rosemount
S. Conditions of Payment All services provided by Grantee pursuant to this agreement must be performed to
the satisfaction of the State, as determined in the sole discretion of its Authorized Representative. Further, all
services provided by the Grantee must be in accord with all applicable federal, state, and local laws, ordinances,
rules and regulations. Requirements of receiving grant funds may include, but are not limited to: financial
reconciliations of payments to Grantees, site visits of the Grantee, programmatic monitoring of work performed
by the Grantee and program evaluation. The Grantee will not be paid for work that the State deems
unsatisfactory, or performed in violation of federal, state or local law, ordinance, rule or regulation.
6. Authorized Representatives
6.1 State's Authorized Representative The State's Authorized Representative for purposes of
administering this agreement is Nancy La Plante, Grant Coordinator, Minnesota Department of
Health, 625 Robert Street North, P.O. Box 64975, St. Paul, Minnesota 55164-0975, 651-201-
3651, nancyjo.laplantegstate.mn.us, or her successor, and has the responsibility to monitor the
Grantee's performance and the final authority to accept the services provided under this
agreement. If the services are satisfactory, the State's Authorized Representative will certify
acceptance on each invoice submitted for payment.
6.2 Grantee's Authorized Representative The Grantee's Authorized Representative is Andy
Brotzler, Director of Public Works/City Engineer, 2875 145th Street West, Rosemount,
Minnesota 55068-4997, 651-322-2025, andy.brotzlera,,ci.rosemount.mn.us, or his successor.
The Grantee's Authorized Representative has full authority to represent the Grantee in fulfillment
of the terms, conditions, and requirements of this agreement. If the Grantee selects a new
Authorized Representative at any time during this agreement, the Grantee must immediately
notify the State in writing, via e-mail or letter.
7. Assignment,Amendments, Waiver, and Merger
7.1 Assignment The Grantee shall neither assign nor transfer any rights or obligations under this
agreement without the prior written consent of the State.
7.2 Amendments If there are any amendments to this agreement, they must be in writing.
Amendments will not be effective until they have been executed and approved by the State and Grantee.
7.3 Waiver If the State fails to enforce any provision of this agreement, that failure does not waive the
provision or the State's right to enforce it.
7.4 Merger This agreement contains all the negotiations and agreements between the State and the
Grantee. No other understanding regarding this agreement, whether written or oral, may be used to bind
either party.
8. Liability The Grantee must indemnify and hold harmless the State, its agents, and employees from all
claims or causes of action, including attorneys' fees incurred by the State, arising from the performance of this
agreement by the Grantee or the Grantee's agents or employees. This clause will not be construed to bar any
legal remedies the Grantee may have for the State's failure to fulfill its obligations under this agreement.
Page 4 of 8
M I N N E S O T A Standard Grant Template Version 1.4,6/14
DHGrant Agreement Number
DEPARTMENT DIH EAETH Between the Minnesota Department of Health and the city of Rosemount
Nothing in this clause may be construed as a waiver by the Grantee of any immunities or limitations of liability
to which Grantee may be entitled pursuant to Minnesota Statutes Chapter 466, or any other statute or law.
9. State Audits Under Minnesota Statutes section 16B.98, subdivision 8, the Grantee's books, records,
documents, and accounting procedures and practices of the Grantee, or any other relevant party or transaction,
are subject to examination by the State, the State Auditor, and the Legislative Auditor, as appropriate, for a
minimum of six (6) years from the end of this grant agreement, receipt and approval of all final reports, or the
required period of time to satisfy all state and program retention requirements, whichever is later.
10. Government Data Practices and Data Disclosure
10.1 Government Data Practices Pursuant to Minnesota Statutes Chapter 13.05, Subd. 11(a), the
Grantee and the State must comply with the Minnesota Government Data Practices Act as it applies to
all data provided by the State under this agreement, and as it applies to all data created, collected,
received, stored, used, maintained, or disseminated by the Grantee under this agreement. The civil
remedies of Minnesota Statutes section 13.08 apply to the release of the data referred to in this clause by
either the Grantee or the State.
If the Grantee receives a request to release the data referred to in this clause, the Grantee must
immediately notify the State. The State will give the Grantee instructions concerning the release of the
data to the requesting party before any data is released. The Grantee's response to the request must
comply with the applicable law.
10.2 Data Disclosure Pursuant to Minnesota Statutes section 270C.65, subdivision 3, and all other
applicable laws, the Grantee consents to disclosure of its social security number, federal employee tax
identification number, and Minnesota tax identification number, all of which have already been provided
to the State, to federal and state tax agencies and state personnel involved in the payment of state
obligations. These identification numbers may be used in the enforcement of federal and state tax laws
which could result in action requiring the Grantee to file state tax returns and pay delinquent state tax
liabilities, if any.
11. Ownership of Equipment
The State shall have the right to require transfer of all equipment purchased with grant funds (including
title) to the State or to an eligible non-State party named by the State. This right will normally be exercised
by the State only if the project or program for which the equipment was acquired is transferred from one
grantee to another.
12. Ownership of Materials and Intellectual Property Rights
12.1 Ownership of Materials The State shall own all rights, title and interest in all of the materials
conceived or created by the Grantee, or its employees or subgrantees, either individually or jointly with
others and which arise out of the performance of this grant agreement, including any inventions, reports,
studies, designs, drawings, specifications, notes, documents, software and documentation, computer
based training modules, electronically, magnetically or digitally recorded material, and other work in
whatever form ("materials").
Page 5 of 8
M I N N E S O T A Standard Grant Template Version I.4,6/14
DHGrant Agreement Number
DEPARTMENT or HEALTH Between the Minnesota Department of Health and the city of Rosemount
The Grantee hereby assigns to the State all rights, title and interest to the materials. The Grantee shall,
upon request of the State, execute all papers and perform all other acts necessary to assist the State to
obtain and register copyrights, patents or other forms of protection provided by law for the materials.
The materials created under this grant agreement by the Grantee, its employees or subgrantees,
individually or jointly with others, shall be considered "works made for hire" as defined by the United
States Copyright Act. All of the materials, whether in paper, electronic, or other form, shall be remitted
to the State by the Grantee. Its employees and any subgrantees shall not copy, reproduce, allow or cause
to have the materials copied, reproduced or used for any purpose other than performance of the
Grantee's obligations under this grant agreement without the prior written consent of the State's
Authorized Representative.
12.2 Intellectual Property Rights Grantee represents and warrants that materials produced or used
under this grant agreement do not and will not infringe upon any intellectual property rights of another
including but not limited to patents, copyrights, trade secrets,trade names, and service marks and names.
Grantee shall indemnify and defend the State, at Grantee's expense, from any action or claim brought
against the State to the extent that it is based on a claim that all or parts of the materials infringe upon
the intellectual property rights of another. Grantee shall be responsible for payment of any and all such
claims, demands, obligations, liabilities, costs, and damages including, but not limited to, reasonable
attorney fees arising out of this grant agreement, amendments and supplements thereto, which are
attributable to such claims or actions. If such a claim or action arises or in Grantee's or the State's
opinion is likely to arise, Grantee shall at the State's discretion either procure for the State the right or
license to continue using the materials at issue or replace or modify the allegedly infringing materials.
This remedy shall be in addition to and shall not be exclusive of other remedies provided by law.
13. Workers'Compensation The Grantee certifies that it is in compliance with Minnesota Statutes section
176.181, subdivision 2, which pertains to workers' compensation insurance coverage. The Grantee's employees
and agents, and any contractor hired by the Grantee to perform the work required by this Grant Agreement and
its employees, will not be considered State employees. Any claims that may arise under the Minnesota
Workers' Compensation Act on behalf of these employees, and any claims made by any third party as a
consequence of any act or omission on the part of these employees, are in no way the State's obligation or
responsibility.
14. Publicity and Endorsement
14.1 Publicity Any publicity given to the program, publications, or services provided resulting from
this grant agreement, including, but not limited to, notices, informational pamphlets, press releases,
research, reports, signs, and similar public notices prepared by or for the Grantee or its employees
individually or jointly with others, or any subgrantees shall identify the State as the sponsoring agency
and shall not be released without prior written approval by the State's Authorized Representative, unless
such release is a specific part of an approved work plan included in this grant agreement.
14.2 Endorsement The Grantee must not claim that the State endorses its products or services.
15. Termination
15.1 Termination by the State or Grantee The State or Grantee may cancel this grant agreement at any
time, with or without cause, upon thirty (30) days written notice to the other party.
Page 6 of 8
M w x E s o T A Standard Grant Template Version 1.4,6/14
DHGrant Agreement Number
DEPARTMENT OF HEALTH Between the Minnesota Department of Health and the city of Rosemount
15.2 Termination for Cause If the Grantee fails to comply with the provisions of this grant
agreement, the State may terminate this grant agreement without prejudice to the right of the State
to recover any money previously paid. The termination shall be effective five business days after the
State mails, by certified mail, return receipt requested, written notice of termination to the Grantee at
its last known address.
15.3 Termination for Insufficient Funding The State may immediately terminate this agreement if it
does not obtain funding from the Minnesota legislature or other funding source; or if funding cannot be
continued at a level sufficient to allow for the payment of the work scope covered in this agreement.
Termination must be by written or facsimile notice to the Grantee. The State is not obligated to pay for
any work performed after notice and effective date of the termination. However, the Grantee will be
entitled to payment, determined on a pro rata basis, for services satisfactorily performed to the extent
that funds are available. The State will not be assessed any penalty if this agreement is terminated
because of the decision of the Minnesota legislature, or other funding source, not to appropriate funds.
The State must provide the Grantee notice of the lack of funding within a reasonable time of the State
receiving notice of the same.
16. Governing Law, Jurisdiction, and Venue This grant agreement, and amendments and supplements to it,
shall be governed by the laws of the State of Minnesota. Venue for all legal proceedings arising out of this grant
agreement, or for breach thereof, shall be in the state or federal court with competent jurisdiction in Ramsey
County, Minnesota.
17. Lobbying Ensure funds are not used for lobbying, which is defined as attempting to influence legislators or
other public officials on behalf of or against proposed legislation. Providing education about the importance of
policies as a public health strategy is allowed. Education includes providing facts, assessment of data, reports,
program descriptions, and information about budget issues and population impacts, but stopping short of
making a recommendation on a specific piece of legislation. Education may be provided to legislators, public
policy makers, other decision makers, specific stakeholders, and the general community.
IN WITNESS WHEREOF, the parties have caused this grant agreement to be duly executed intending to be bound
thereby.
APPROVED:
I. Grantee 2. State Agency
The Grantee certifies that the appropriate persons(s)have executed the Grant Agreement approval and certification that State funds have been
grant agreement on behalf of the Grantee as required by applicable encumbered as required by Minn.Stat.§§16A.15 and 16C.05.
articles,bylaws,resolutions,or ordinances.
By: By:
(with delegated authority)
Title: Title:
Date: Date:
Page 7 of 8
M N N E s O T Standard Grant Template Version 1.4,6/14
DllGrant Agreement Number
DEPARTMENT 01H EAUH Between the Minnesota Department of Health and the city of Rosemount
By:
Title:
Date:
Distribution:
Agency—Original(fully executed)Grant Agreement
Grantee
State Authorized Representative
Page 8 of 8
M I N N E S O T A Minnesota Department of Health (MDH) Exhibit A
lvff3H Well Management Section
P.O. Box 64975
St. Paul, Minnesota 55164-0975
DEPARTMENToF HEALTH 651-201-4600 or 800-383-9808
www.health.state.mn.us/divs/eh/wells
Public Water-Supply Well Sealing Grant Invoice
GRANTEE INFORMATION Minnesota Unique Well Number:
Minnesota Well and Boring Sealing Number:*
Facility Name:
Address:
Grant Contact Person:
Telephone: Fax:
Email:
INVOICE INFORMATION
Is this the final invoice? ❑ Yes ❑ No
What dates does this invoice cover?
EXPENDITURE DESCRIPTION (Use an additional page if necessary.)
a. Contractor's total cost to seal the well $
Eligible Amounts Ineligible Amounts
b. Contractor's itemized costs to seal the well:
Investigative $
Mobilization/Demobilization $
Labor $
Equipment $
Materials $
Supplies $
Disposal Fee $
Permit/Notification Fee $
Reports $
Administrative $
General contractor or consulting $
c. Contractor's total eligible costs to seal the well $
d. Well owner's costs(50%of item c's eligible costs and all $ $
ineligible costs)
Page 1 of 2
e. MDH match (50%of item c's eligible costs) $
DISCLAIMER AND SIGNATURE
I declare that no part of this claim has been previously billed to MDH, and that the total expenditures reflect only charges
related to sealing unused public water-supply well Grant Agreement. I also declare the data on this document is correct and all
transactions that support this claim were made in accordance with all applicable federal and state statutes and regulations.
Authorized Grantee Signature Date
FOR MDH USE ONLY
Grant Manager Signature Date
PO: Approved by:
Period of Service: Date sent to F.S.:
* If the well doesn't have a Minnesota Unique Well Number,obtain the Minnesota Well and Boring Sealing Number from the licensed well contractor.
ehcommon\clean water fund\well sealing grants\public\fy 2015-2016\invoice form.docx 01/04/20158
Page 2 of 2
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